Summary of Work: Nitric oxide is an important inter- and intracellular messenger implicated in the pathogenesis of septic shock. Inhibition of nitric oxide synthase is under investigation as a treatment for hypotension in septic shock. In addition to the vasodilating effect of nitric oxide, this messenger also has effects on platelets and immune cells. In this investigation, we are examining the role of the nitric oxide pathway as a modulator of immune cell function. We have been unable to create conditions under which human phagocytes, in particular neutrophils, endogenously produce nitric oxide (J Immunol, 153:1825- 1834, 1994). The refore, the ability of nitric oxide produced by other cells, such as endothelium and epithelium, to alter the function of human phagocytes is being explored. We have found that, in addition to upregulating tumor necrosis factor- alpha production (J Immunol, 152:4102-4109, 1994), nitric oxide modulates IL-8 message transcription and release in human neutrophil preparations. However, contrary to other reports, nitric oxide does not directly alter neutrophil chemotaxis (J Infect Dis, in press, 1997). Recently, we have confirmed that nitric oxide regulates cytokine production using a U-937 monocytic cell line transfected to express murine inducible nitric oxide synthase (Blood, 90:1160-1167, 1997). Further investigation of this effect has resulted in the description of a cGMP-independent signaling pathway for nitric oxide (J Biol Chem, 272:5959-5965, 1997). Future experiments are planned to better characterize this signal transduction pathway in both U-937 cells and freshly isolated human phagocytes and document its effect on cell function and differentiation.